He Chen, Ma Yuan-Liang, Wang Chuang-Shi, Song Ying, Tang Xiao-Fang, Zhao Xue-Yan, Gao Run-Lin, Yang Yue-Jin, Xu Bo, Yuan Jin-Qing
Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
Catheter Cardiovasc Interv. 2017 Mar;89(S1):549-554. doi: 10.1002/ccd.26978.
This retrospective, single-center, observational analysis from prospectively collected database evaluated whether left dominance affected the long-term outcomes of acute coronary syndrome patients undergoing percutaneous coronary intervention, and whether the effect was independent of SYNTAX score.
Left dominance is believed to be associated with worse prognoses. The anatomical SYNTAX score is a scoring system based on the complexity and severity of coronary lesions and is thought to be a prognostic tool to predict short- and long-term outcomes. There are few studies about whether the effect of left dominance is independent of SYNTAX score.
Between January 2013 and December 2013, 6255 consecutive acute coronary syndrome patients who were admitted to Fuwai hospital and underwent percutaneous coronary intervention (PCI) were enrolled in this study. Based on coronary dominance and the calculation methods of the SYNTAX score, patients were divided into a left-dominant group (LD group; 390 patients) and a right-dominant or co-dominant group (RD + Co group, 5865 patients).
The 2-year mortality rate was significantly higher in the LD group than in the RD + Co group (2.58% vs. 1.23%, P = 0.024). In multivariate Cox analysis, the independent predictors of mortality were coronary dominance, IABP support, age, baseline SYNTAX score, and ejection fraction.
LD was an independent predictor of long-term mortality in ACS patients undergoing PCI. The effect of LD still existed after adjustment for several important variables and was independent of SYNTAX score. © 2017 Wiley Periodicals, Inc.
本项回顾性、单中心、观察性分析利用前瞻性收集的数据库，评估左优势型是否影响接受经皮冠状动脉介入治疗的急性冠状动脉综合征患者的长期预后，以及该影响是否独立于SYNTAX评分。
左优势型被认为与较差的预后相关。解剖学SYNTAX评分是一种基于冠状动脉病变的复杂性和严重程度的评分系统，被认为是预测短期和长期预后的一种预后工具。关于左优势型的影响是否独立于SYNTAX评分的研究较少。
2013年1月至2013年12月期间，连续纳入6255例入住阜外医院并接受经皮冠状动脉介入治疗（PCI）的急性冠状动脉综合征患者。根据冠状动脉优势型及SYNTAX评分的计算方法，将患者分为左优势型组（LD组；390例患者）和右优势型或共优势型组（RD+Co组，5865例患者）。
LD组的2年死亡率显著高于RD+Co组（2.58%对1.23%，P=0.024）。在多因素Cox分析中，死亡率的独立预测因素为冠状动脉优势型、主动脉内球囊反搏（IABP）支持、年龄、基线SYNTAX评分和射血分数。
LD是接受PCI的ACS患者长期死亡率的独立预测因素。在调整了几个重要变量后，LD的影响仍然存在，且独立于SYNTAX评分。©2017威利期刊公司
